女性绝经相关症状特点及绝经激素治疗认知状况的调查分析  

Investigation and analysis of characteristics of menopause-related symptoms andmenopausal hormone therapy cognition status

作　　者：王丽[1] 李芬[1] 于学文[1] 杨文方[1] 白娥[1] 王青 邓阳 WANG Li;LI Fen;YU Xuewen;YANG Wenfang;BAI E;WANG Qing;DENG Yang(Department of Gynecology and Obstetrics,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院妇产科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2024年第4期629-636,共8页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划资助项目(No.2022SF-163)。

摘　　要：目的 调查更年期女性绝经相关症状的特点及对绝经激素治疗(MHT)的认知状况。方法 选择就诊于西安交通大学第一附属医院有绝经相关症状的619例更年期女性为研究对象,采用调查问卷的方式收集资料,分析绝经相关症状的特点,探讨更年期女性对MHT的认知状况及疗效。结果 371例围绝经期女性中绝经相关症状发生率位于前3位的分别是:疲乏(69.81%)、失眠(66.85%)、潮热出汗(58.22%),248例绝经后女性中绝经相关症状发生率位于前3位的分别是:潮热出汗(64.11%)、骨关节痛(60.89%)、疲乏(56.85%)。绝经后女性的失眠、疲乏发生率显著低于围绝经期女性(P<0.01),而骨关节痛、泌尿系感染、阴道干涩性交痛的发生率显著高于围绝经期女性(P<0.01)。围绝经期和绝经后女性的Kupperman评分比较无统计学差异(P>0.05),但评分程度分布比较有统计学差异(P<0.05);围绝经期女性轻度占比最高,绝经后女性中度占比最高。绝经后女性的不同绝经年龄、绝经年限、绝经方式之间Kupperman评分比较有统计学差异(P<0.05);绝经年龄越早、绝经年限越短Kupperman评分越高;手术绝经者Kupperman评分显著高于自然绝经者(P<0.05)。多因素Logistic回归分析结果显示,年龄45~54岁、退休或无业、配偶疾病或去世、性生活不正常、文化程度高是绝经相关症状发生的危险因素(P<0.05),家庭收入高、>3次/周的运动是绝经相关症状发生的保护因素(P<0.05)。更年期女性对MHT了解途径占比最高为网络(39.92%),对MHT的担忧占比最高为肿瘤(33.67%)。465例(89.77%)无MHT禁忌证的更年期女性,治疗后症状显著改善(P<0.05)。结论 更年期女性绝经相关症状显著,年龄越早、绝经年限越短及手术绝经者症状更为严重,应关注绝经对更年期女性健康的影响并增加专业医师指导,提高MHT使用率以改善更年期女性的生活质量。Objective To investigate the characteristics of menopause-related symptoms and cognition status of menopausal hormone therapy(MHT)among menopausal women.Methods A total of 619 menopausal women with menopause-related symptoms who were admitted to The First Affiliated Hospital of Xi’an Jiaotong University were selected as the study subjects.Data were collected by questionnaire to analyze the characteristics of menopause-related symptoms,and the menopausal women’s cognitive status of MHT and therapeutic effects were explored.Results Among 371 perimenopausal women,the menopause-related symptoms with the top three rates were fatigue(69.81%),insomnia(66.85%),and hot flush-sweating(58.22%).Among 248 postmenopausal women,the menopause-related symptoms with the top three rates were hot flashes and sweating(64.11%),bone and joint pain(60.89%),and fatigue(56.85%).The incidence of insomnia and fatigue in postmenopausal women was significantly lower than that in perimenopausal women(P<0.01),while the incidence of bone and arthralgia,urinary system infection,vaginal dryness and painful intercourse was significantly higher than that in perimenopausal women(P<0.01).There was no significant difference in Kupperman score between perimenopausal and postmenopausal women(P>0.05),but score degree distribution differed significantly(P<0.05).Perimenopausal women had the highest proportion of mild score while postmenopausal women had the highest proportion of moderate score.There were significant differences in Kupperman score among postmenopausal women with different menopause ages,menopause years and menopause mode(P<0.05).The earlier menopause age and shorter menopause years,the higher Kupperman score was;the Kupperman score was significantly higher in surgical menopause than in natural menopause(P<0.05).Multivariate Logistic regression analysis showed that age of 45-54 years old,retirement or unemployment,spouse’s disease or death,abnormal sexual life,and high education level were the risk factors for the occurrence of menopaus

关 键 词：更年期 绝经相关症状 绝经激素治疗(MHT) 调查分析 影响因素 

分 类 号：R711.59[医药卫生—妇产科学]